Accident and Emergency Departments

Robert Halfon Excerpts

Tuesday 10th September 2013 Commons Chamber

[Mr Hunt]

I hope that when the hon. Gentleman looks at today’s announcement it will reassure him that we are addressing not just the immediate pressures in the most difficult areas, but the underlying pressures. That 25% increase at Whiston—I pay tribute to the staff in its A and E department, who will no doubt be working extremely hard to cope with it—has come about because we have not had better alternatives to A and E and because departments have often found it difficult to discharge people from hospital into the community, which has further increased the pressure on them. What we have announced in the past few months and today will make a real difference to alleviating those pressures.

[Robert Halfon (Harlow) (Con)]

My right hon. Friend will be aware that Princess Alexandra hospital in Harlow is an outstanding hospital with outstanding staff. My constituents will be incredibly grateful for the £5.7 million announced today, which comes on top of a £470,000 grant provided to St Clare hospice by the Minister of State, Department of Health, the hon. Member for North Norfolk (Norman Lamb), who has responsibility for care. Does my right hon. Friend agree that that shows that this Government invest in the NHS in Harlow, and will he come to Princess Alexandra hospital to see the excellent work that is being done?

[Mr Hunt]

I would be delighted to go to Princess Alexandra hospital, where I am sure the work is indeed excellent. I agree with my hon. Friend’s fundamental point, which is that this Government took the very difficult decision not just to protect the NHS budget, but to increase it. That was described as irresponsible by the right hon. Member for Leigh (Andy Burnham). We are spending £600 million more in real terms this year than we would have spent if we had followed his advice. That makes a very big difference to hospitals such as that in my hon. Friend’s constituency.

East of England Ambulance Service

Robert Halfon Excerpts

Tuesday 25th June 2013 Westminster Hall

[Dr Thérèse Coffey (Suffolk Coastal) (Con)]

It is a pleasure to serve under your chairmanship, Mr Howarth. I thank my hon. Friend the Member for Witham (Priti Patel) for leading this debate so well; her speech was a tour de force. I will bear in mind your time limit, Mr Howarth, although I could take the whole 90 minutes to tell the sad tale. It is a pleasure to follow my hon. Friend the Member for North West Norfolk (Mr Bellingham). The East of England Ambulance Service NHS Trust is actually responsible for out-of-hours care in Norfolk, so the left hand should be talking to the right hand.

I also thank the Minister of State, Department of Health, my hon. Friend the Member for North Norfolk (Norman Lamb), and the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), who started work on the issue. It was right for my hon. Friend the Member for Central Suffolk and North Ipswich, a doctor, to take the lead on such matters in Suffolk, but pushing on, consistent performance from colleagues across the counties in the east of England has brought the issue to the fore.

As I suggest, this is a sad tale that started some time ago. My timelines of the issue start in the middle of 2011. We are driven by the experiences of our patients —those who have suffered. Let us be honest: the vast majority of people in our constituencies have a good ambulance service. Once an ambulance arrives, care is very good; nobody denies that. However, too often that excellence of service is concentrated in certain areas of the region in order to meet a false regional performance target, and almost everything else is put aside. It does not matter if only 50% of people in south Norfolk get an ambulance within 90 minutes as long as the regional target is met. That is all that matters to the leadership and the board of the East of England Ambulance Service NHS Trust.

We have had a long series of meetings, Care Quality Commission inspections and promises of change. Transparency has been lacking. The trust has been dragged kicking and screaming into showing its performance targets in a meaningful way—first by county, now at clinical commissioning group level—but that took a long time. It used to say, “You can look in the minutes of your local primary care trust to find response times.” It is unacceptable for those at the very top to say, “Well, that’s all right; we’re hitting our regional target.”

I have used the constituency of the hon. Member for Copeland (Mr Reed) to say that if it can happen in Cumbria and Cornwall, it can certainly happen in Norfolk and Suffolk. It is important that the Opposition spokesman does not try to drag party politics into this debate or talk about finances. The issue is about those at the top having wrong priorities and forgetting that every patient matters.

I have never had to call an ambulance in the east of England, or indeed at all, but I like to think that if I did, I could have some confidence that it would arrive in time. In reality, however, there are not enough ambulances and not enough staff. Mr Andrew Morgan recognised that early on when he came into office as interim chief executive. As Dr Marsh pointed out in his excellent report,

“the current leadership from the board just isn’t strong enough to take them forward…there is a lack of focus and grip from the board which has contributed towards the deterioration of performance across the trust.”

Many of the issues breaking open at the moment have been deteriorating for some time. The non-executives have not shown leadership by asking hard questions and going beneath the surface; they have relaxed and considered only the top regional performance target.

I thank our local newspapers, the East Anglian Daily Times and the Eastern Daily Press. Nigel Pickover and Terry Hunt have done good things to keep up the pressure and stand up for their readers, our constituents, who are patients of the East of England Ambulance Service NHS Trust.

[Robert Halfon (Harlow) (Con)]

And the Harlow Star.

[Dr Coffey]

And the Harlow Star, apparently.

In December 2011, we finally got a meeting with the Health Minister and a range of other people around the table who could have fixed the issue. We were promised that there would be change and more focus at county level, and that patients mattered. The postcode data released in November 2011 showed that that had not been the case. We have never been able to get data at that level since then, because the trust does not want to share it with us and, frankly, I am not sure that I should spend all my time on freedom of information requests.

One of the things agreed at that meeting was that contracts would change. That did not happen, which is one issue relating to trust. In October 2012, Hayden Newton resigned. Coincidentally, that was a week after a series of complaints, including about the case of Nora Dennington, whose family finally went to the press to get an answer after three months. To be fair to Maria Ball, the former chairman of the trust, she got answers to those complaints then and there, and within a week, Hayden Newton resigned.

However, Newton was still on the payroll until the end of March 2013, and the chair at the time gave him a glowing tribute, saying that he would be greatly missed and

“a hard act to follow”

and that under his leadership, front-line staff were still being recruited and quality of care had improved. The chair also said:

“Thanks to Hayden’s stewardship, EEAST is now a stable, sustainable and financially sound organisation”.

I am afraid that the Marsh report blows that out of the water.

I could go on about all the different meetings, but I will not, as I am conscious of the time. What I will say is that patients’ complaints were not being answered, and patients were not being treated as individuals. The board should have seen it in the survey and the climb in sickness rates, and the CQC should have done more than tick the box saying that the trust had passed staff compliance on the basis that appraisals had been done. There was an element of external scrutiny by the CQC, the strategic health authority and, to some extent, Monitor, which did not approve the foundation trust status application, but passed the trust on the governance rating. All those different regulators, as well as the leadership of the board, need to look at themselves to understand why they, in effect, let people down. The board was fixated on getting foundation trust status; it was only focused on the regional target, and it did not matter that residents in Suffolk were being failed, as long as the regional target was okay.

Moving forward, my hon. Friends who have spoken are absolutely right: it is imperative that the remaining non-executive directors resign their posts immediately and that the NHS Trust Development Authority acts on that. The ideal solution for me would be to ask Dr Marsh to come in, whether permanently or on an interim basis, to turn around our ambulance trust, because he has the skills to make that happen. I want Dr Harris to succeed; however, it is important that we do not rely on the management speak to which my hon. Friend the Member for North West Norfolk referred, but recognise that we need to clean the slate.

There are of course external factors—we need to work with GPs and A and E—but much of the problem is internal, because there were not enough training places or staff. Incidentally, it is right that Whitehall should not seek to control everything, but it is vital that MPs have confidence that the NHS Trust Development Authority will take the matter seriously. Furthermore, CQC needs to be quicker—not to be rash, but not to be tick-box driven. It failed the ambulance trust and, more recently, it decided to withdraw from a meeting with MPs to talk about its reaction to the trust plan issued in April.

I could have spoken for longer, Mr Howarth, and I have spoken for longer than you requested, but I genuinely want to ensure that our patients, constituents and residents can rest assured that we will not stop continuing pursuit of excellence on their behalf, wherever they live in our great part of the country—they deserve nothing but the best. Again, if Cumbria and Cornwall can do it, we can certainly do it in Suffolk, Norfolk, Essex and Cambridgeshire. Frankly, until those non-executive directors go, we will not have confidence in the leadership of the trust to make the difference.

[Robert Halfon (Harlow) (Con)]

It is a pleasure to serve under your chairmanship, Mr Howarth. I give my sincerest congratulations to my near neighbour and hon. Friend the Member for Witham (Priti Patel), who has led the campaign against the shocking performance of the East of England Ambulance Service NHS Trust.

The East of England ambulance service continues to give my constituents and me huge concern. As my hon. Friend said, however, I want to make it clear that those worries are not aimed at front-line staff, for whom I have nothing but admiration, especially the senior staff and the paramedics in Harlow. They do a tough job and give 100% to their work; I am proud that we have such extraordinary people living in Harlow and throughout the east of England. The staff, however, are lions being led by donkeys—that is the truth of the matter, as so brilliantly highlighted by my hon. Friend.

At the end of 2012-13, the East of England ambulance service had failed to reach its targets, whether for category A response times for calls to do with life-threatening situations, the less serious green calls or even the ability to pick up the phone on time. Not only is the trust failing to hit demanding targets, but my post bag is regularly filled with letters from local residents complaining about the service that they have received. I have also had staff contact me to complain that they feel they are offering an inadequate service because of the shocking performance of senior managers.

It is outrageous that when I have raised constituents’ problems with the ambulance service, it has taken an unacceptably long time to respond. For example, I wrote to the trust about a serious case in which one person had, tragically, died. The trust did get back to me and acknowledged that its response was unacceptable, contributing to the man’s death, but it had taken nearly five months to respond to my letter on behalf of the family—that is a disgrace.

We have to see change in three areas: we need better resources, targeted at delivering better patient outcomes; the management system urgently needs restructuring; and we need to show staff that they are valued, increasing their skills, so that they continue to make progress. Only by doing those things can people in Harlow and throughout Essex and the east of England get the treatment that they deserve.

For far too long, I have had residents contacting me about the poor level of service. Nearly all the concerns are focused on delays that their family or friends have suffered when waiting for an ambulance or during the handover time in hospital. A tragic case is that of cyclist Robert Tyler, who died by the roadside in my constituency after waiting 45 minutes for an ambulance, despite being only three minutes away from A and E. Sadly, such anecdotes are borne out by the statistics and, as I said, the trust failed to meet its operational targets last year.

I was glad to receive a letter from Dr Geoffrey Harris that claimed he is starting to see signs of improvement. I hope that is so, but on speaking to a worker from the ambulance service yesterday, it was troubling to hear that they felt that little had improved. The worker made the important point that we need more ambulances on the road, telling me that the rapid response vehicles were only being used to ensure that targets were hit. To deliver the best patient care, according to the worker, rapid response vehicles should be in addition to ambulances, not a replacement for them. That view is held across the trust, with more than 300 staff supporting a move calling on the management to claim the A19 target only when an ambulance arrives.

I was disturbed when a constituent told me about her 97-year-old mother who had fallen, hurt her leg and was unable to stand. The first responder arrived quickly and provided good care, but because no ambulances were available, my constituent was left waiting in pain for eight hours. That is absolutely unacceptable, and the new chairman must look at providing more ambulances, so that we can minimise patient suffering and provide a more efficient service.

When I speak to local staff, time and time again they bring up problems with the management structure and their dissatisfaction with it. Some have pointed to directors whom they hold accountable for the problems in the trust; those directors have not resigned, despite the strong pressure to do so. Dr Marsh’s report, as has been highlighted, is no different: he has made it clear that some trust non-executive directors need to resign. He points to an inability of the board to claim responsibility, a lack of clear vision, too much management and no tangible recruitment plan.

It is good news that the new chairman of the trust has stated that he will be making changes to the board, but I join my hon. Friends in calling for five board members to resign and, if possible, for them to be taken to court to be sued for legal negligence—I wish that could be the case. It is shocking that they have been allowed to continue when their failings have been made so apparent. They have put their people’s lives at risk and they have treated my local residents of Harlow shoddily. The board must be refreshed, replacing those members with people who have a proven track record of driving up standards.

I have heard of other problems from workers and residents. Staff are always praised, but staff morale is the worst of all the ambulance trusts in England—it is chronically low. Staff are embarrassed by how long an ambulance can take to reach patients. Sickness levels are high, with an 8.8% sickness rate—almost double the national average for ambulance trusts in England. Also, there is lack of training, with staff telling me that they feel unsupported; records show that the level of completed training days is abysmally low and last year only 45% of appraisals actually took place.

I am pleased that Dr Harris is making some changes, but action needs to be far quicker. At previous meetings with the trust, it seemed to be suggesting that Government funding was partly to blame, but Dr Marsh’s review blows that excuse out of the water. As my hon. Friend the Member for Witham says, the review found that the trust is funded above the average for ambulance trusts, possibly by several million pounds.

The board must take full responsibility for the problems that have plagued the service over the past few years. Action should be taken, including provision of a proper training programme for existing staff, a coherent recruitment plan to rebalance the staff ratio and direction of resources so that more ambulances are on the roads. I favour the ambulance service being broken up, so that there is an Essex ambulance service, because the East of England service is far too big. Genuinely, with the right management and the right resources, we can deliver some of the best care to my constituents in Harlow, to Essex and throughout the east of England.

[Mr George Howarth (in the Chair)]

I will call Peter Aldous in a moment and the Opposition spokesman at 10.40 am. If the two remaining speakers before the Front-Bencher take five minutes each, that should just about cover the time.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

It is a pleasure to serve under your chairmanship, Mr Howarth. I begin by paying tribute to my hon. Friend the Member for Witham (Priti Patel) for bringing this matter, quite properly, to Westminster Hall this morning, for giving an excellent speech, and for her outstanding campaign on behalf of her constituents. In simple terms, she seeks to hold the ambulance trust, which clearly has performance figures that are simply unacceptable—they are the lowest in the country—to account. There is a clear feeling of anger—that is no criticism at all; it is based on frustration. I know that my hon. Friend the Member for Suffolk Coastal (Dr Coffey) has joined her in this admirable work, and despite raising the issue and notwithstanding all their efforts, they are frustrated and angry because they feel that it has taken many months for the trust to even begin to make some sort of attempt to address the inherent problems that it clearly faces.

Another thing that clearly emerges from the many interventions and excellent speeches by hon. Members this morning is that there is wholesale support, and many tributes, for the staff—the front-line workers. Nobody is for one moment saying that there is any failing on their part. The failing is clear: it is failing at a leadership level and at board level. There is a failing of leadership, which must be addressed as a matter of some urgency.

I only have about 12 minutes to address the many points that have been made, so the usual rules apply: anybody who has asked a question that I am not able to answer in my short speech will, of course, get a written answer. I just want to deal quickly with the important point made by my hon. Friend the Member for North West Norfolk (Mr Bellingham), who asked whether the usual rules that apply to non-executives on public limited companies, or on companies that are listed on the stock exchange and so on, apply to non-executives who are appointed to NHS trusts. I must tell him that the rules are not the same; their responsibilities and duties are different. I will provide more detail in a letter to my hon. Friend, but it is not as simple as it is when people are non-executive directors on other bodies, where it could be said there is much more accountability and much more of a duty on them to resign when there have been the sorts of failings that we have heard about today—if that was applied to a business, for example.

[Robert Halfon]

Will the Minister give way?

[Anna Soubry]

May I just make one other point? Then I shall be more than happy to give way, although the clock is against me, as my hon. Friend will appreciate.

Here we have another issue that should concern, as I know it does, all hon. Members, on both sides of the House. It is the culture that is now becoming clear. I take the view that it is not a new culture. I suspect that it has been there for many years. It is just that it is now being exposed, often through the admirable work of Members of Parliament and because of the work of my right hon. Friend the Secretary of State for Health. That is a mates culture, where people’s priority is to protect their mates, systems and procedures, as opposed to what should be the absolute priority for somebody in the NHS, which is to protect the patient—not their friends and the structures, but the patient—and also, of course, the hard-earned money of the taxpayer.

[Robert Halfon]

My hon. Friend will have heard me set out the treatment of Harlow residents. Does she agree with me and with our hon. Friend the Member for South Norfolk (Mr Bacon) that the East of England ambulance trust is too big and should be broken up, and that we should restore the Essex ambulance service trust?

[Anna Soubry]

That is a good point, but it is not for me to say whether it has any merit that should be taken forward. But clearly it is an important point, which must now be considered.

May I quickly pay tribute to all the very helpful interventions from hon. Friends? My hon. Friend the Member for Broadland (Mr Simpson) talked about the buck passing in the NHS and the recycling. We also heard from my hon. Friends the Members for Maldon (Mr Whittingdale) and for Huntingdon (Mr Djanogly). My hon. Friend the Member for Waveney (Peter Aldous) made an excellent speech. My hon. Friend the Member for Suffolk Coastal also made an excellent and important speech. There were interventions from my hon. Friends the Members for Clacton (Mr Carswell) and for Cambridge (Dr Huppert) and from my right hon. Friend the Member for Saffron Walden (Sir Alan Haselhurst). There were speeches by my hon. Friends the Members for Harlow, for North West Norfolk and for South Norfolk (Mr Bacon). They all made important and good points.

We know that overall in England in 2012-13 the number of emergency calls to ambulance services was 9.08 million—a 6.9% increase. That is an important figure, I would suggest. We know that overall, in England, the performance figures are stable. That does not really assist in this debate, of course, because we also know that the East of England ambulance trust and, I have to say, my own, the East Midlands ambulance trust, have serious failings and the performance figures are simply not good enough.

The best that I can say of the performance of the East of England ambulance trust is that it has not been good. It is clearly recognised as the lowest-performing ambulance trust in England. As with the national picture, its overall poor performance figures hide huge discrepancies between the services and response times in the urban and rural areas that it covers. There are too many stories—we have heard many today—of patients in distress having to wait hours for ambulances, or solo paramedics being sent when an ambulance is needed. Solo paramedics cannot transport patients and might not, for instance, be able to lift or move a patient unaided. It is simply not good enough.

It is clear to me that some hon. Members and many patients might be forgiven for thinking that the trust seems to have forgotten that it is there to serve all patients and not only tick the performance boxes as far as it can. Concentrating resources in towns and effectively abandoning people in the countryside is simply unacceptable.

Schizophrenia Care

Robert Halfon Excerpts

Monday 10th December 2012 Commons Chamber

[Mr Walker]

My hon. Friend makes a very good point. I have had an extremely good paper from St Mungo’s dealing with that very issue.

We also need to do more listening. We must stop talking over people who suffer with psychosis or schizophrenia. They are warm, live human beings. They exist. We tend too often to talk over them and about them, not to them. Certainly there will be times when they are in crisis, but when they are we need a crisis plan so that they can tell us how they want to be treated, looked after and cared for—how we can help to secure their dignity. Then we need to ensure that they have advocates who can sit alongside them and be their voice—someone they trust at a time of crisis, illness and distress.

We need more support for carers—the people who love them, the people who stand by them day in and day out, trying to do the right thing, trying to get them the care that they deserve and require—their champions. Let us not forget in this place the important role that carers play in being the champions. We need much more talking and listening to carers, involving them in the process. They will know so much more about the individual being cared for than probably anyone else.

Then we need to provide more training for people working in the mental health arena. It is a demanding environment. In the acute settings people tend to be admitted who are very ill. The threshold for admittance is so much higher now. The staff need to be trained to deal with and to care for these people. It is no reflection on the staff that I am asking for this. I want to stand shoulder to shoulder with the staff. We want to stand alongside them and help them to deliver the care that they want to deliver, and that their professional pride demands that they deliver.

[Robert Halfon (Harlow) (Con)]

I congratulate my hon. Friend on securing the debate and on his knowledge of the subject. He talks about early intervention. I recently visited the North Essex Partnership NHS Trust, which works on mental health. It puts people into schools to identify children and young people who are developing such problems, which has a huge impact and manages to stop more serious problems developing later.

[Mr Walker]

My hon. Friend makes an excellent point on early intervention. It is about getting there before the crisis occurs and making sure that people who are at risk have the support they need to manage their illness so that they end up in a good place, not a frightening place.

We need more peer support. When someone goes through a mental health crisis, many people tell them that it will get better, but they might not be believed, as things can look pretty dark and desperate at the time. There are many professionals around, but perhaps that person wants to talk with someone who has been there, travelled through the fire they are going through and come out the other side, someone who can sit with them and say, “We’re going to work through this together. I’m not just saying this; I’ve actually done it. I’ve been where you are and I’ve come out the other side. I’m going to take you by the hand and we’re going to walk through this together.” That is peer support, and we need to encourage it and see more of it.

We need more intermediate services, because many people are terrified of going into acute care and too often the experience is not a good one. Being hospitalised is frightening. They do not want to go into acute care because they are terrified by that prospect. Let us think more about intermediate care. When things are getting on top of someone and they are feeling stressed out, that perhaps the ground is going from underneath them and that things are getting out of control, there should be a place they can go in the community, a crisis house, where they can say, “I need help, because I feel that I’m going to have some troubled times ahead.” There they can be told, “Come on in. We’re going to work together for the next couple of weeks. We’re not going to be a crutch and you aren’t going to be here indefinitely, but we will work together for the next five or 10 days or two weeks to get you back on your feet and out there again.”

We also need uniform reporting. I want diversity of provision, because out of diversity comes innovation, but I also want to know what is going on. I want to know when we are successfully meeting the needs of those with psychosis and schizophrenia, but I also want to know when we are not, because that is when we can start doing something about it. With heart disease, cancer or stroke, we can check the league tables and know exactly what is going on, but it is much more difficult with mental health problems, particularly psychosis and schizophrenia, so we need uniform reporting. I am concerned that the Care Quality Commission is stopping its in-patient surveys in mental health wards, which I think is a mistake. I think that it is regressive and that it needs to be revisited. I hope that I can bring the focus of the House to bear on that issue.

Patients need a voice. They need to be able to tell us what is and is not working. Most of all, we need to ensure that people have a chance of living fulfilled and complete lives and that a diagnosis of psychosis or schizophrenia is not the end of the road. They should not hear, “That’s it. Society will now turn its back on you. You’re in real trouble and you’re going to be removed.” We must have absolutely no more of that. We have an obligation to work together on mental health problems in this place and with the NHS and to say to people, “We’re going to work together to get you through this. You have a right to have a chance for a fulfilled, happy and productive life. What has gone before is not good enough, but what will come will be better.”

I have said that I am an enthusiast and an optimist, and I am optimistic. We have the bit between our teeth, we are moving ahead and mental health is being talked about, but schizophrenia and psychosis is a difficult area for politicians and for the public, because so much misinformation and nonsense has been talked about it for so many years. It is going to be the hardest mountain to climb, but climb it we must, because we have an obligation and a duty in this country to take everyone with us. We must not leave people behind because they are ill but take them with us on a journey together—a journey towards wellness.

I have spoken for far too long and I am now much more interested to hear what the Minister has to say. I conclude by saying this: I speak a lot about mental health, but I am fully aware that an army of people out there, professionals and charities, do mental health and do it extremely well. Mind and Rethink are fantastic organisations that campaign daily, hourly, by the minute to ensure that people with mental illness get a voice. As a result of their hard work, those people are getting a voice in here, and that is a good and positive thing.

Business of the House

Robert Halfon Excerpts

Thursday 6th September 2012 Commons Chamber

[Mr Speaker]

Order. I remind the House that there is a further statement to follow. I am keen to accommodate the interest of colleagues in business questions, but if I am to be successful in doing so, brevity from both Back Benchers and Front Benchers alike is now vital.

[Robert Halfon (Harlow) (Con)]

Can we have a debate on intellectual insanity? The Labour-supporting Institute for Public Policy Research is now arguing that motorists are not suffering enough from high petrol taxes, and is calling for more taxes. Is that not surprising, given that high petrol taxes hit the poorest Britons twice as hard as the rich?

[Mr Lansley]

I am interested by what my hon. Friend has said. I seem to recall that, according to Einstein, one of the definitions of that kind of insanity was “to keep doing the same thing while expecting a different result”. I am afraid that that is what we see from the Labour party day by day.

Oral Answers to Questions

Robert Halfon Excerpts

Tuesday 27th March 2012 Commons Chamber

[Mr Burns]

I am extremely grateful to my hon. Friend and, as his question suggested, there is a consultation process. I can give him an assurance that the point that he has made will be fully considered as part of that consultation process.

[Robert Halfon (Harlow) (Con)]

Is my hon. Friend aware that the NHS reorganisation will abolish the strategic health authority in the eastern region, which will save £46 million a year—money that will be spent on front-line services in Harlow and elsewhere?

[Mr Burns]

I am extremely grateful to my hon. Friend for pointing that out. It is crucial that we slim down the bureaucracy and management of the NHS so that we can make savings, so that they can go where they should—to provide more care for patients in the NHS.

Care of the Dying

Robert Halfon Excerpts

Tuesday 17th January 2012 Westminster Hall

[Robert Halfon (Harlow) (Con)]

I congratulate my hon. Friend the Member for Enfield, Southgate (Mr Burrowes) on securing this debate. I have known him as a good friend for nearly 30 years and his values have remained the same over that time.

I welcome this debate because I feel that we need to move the focus of the discussion away from assisted dying and towards quality of life. I became involved with this issue not by accident but through involvement with my local hospice, St Clare. It is one of the most wonderful community organisations with which I have ever had the privilege to be involved, both as a parliamentary candidate in Harlow for many years, and as its MP. St Clare is dedicated to promoting quality of life and care, and it has taught me much about the important role of palliative care and how it needs our support.

I should like to make several brief points, the first of which concerns equity of funding. St Clare hospice in Harlow receives 24% of its funding from the local primary care trust, although other nearby hospices in other PCTs, such as Farleigh hospice or St Francis hospice, receive around 40% of their funding from the PCTs. I welcome the figure of 40% and do not deride it, but it is important to have greater equity of funding. There is also a cliff-edge issue: 70% of charitable hospices have agreements with their local PCT that last for just one year. We need longer-term agreements, so that hospices can plan ahead.

Although we often talk about the big society, the hospice movement existed before that was even mentioned. It has pioneered the big society for many years, and 157 charitable hospices in the United Kingdom receive the bulk of their funding from private and community sources. More than 100,000 people donate their time to local hospices. St Clare hospice has 500 volunteers, and on one occasion, I was pleased to work there as a receptionist. Given what the Government are trying to accomplish in many parts of the public sector, hospices deserve more recognition for their role as part of the big society. They are models of how charitable institutions can raise extra funds, invest in services and train the community, without resources coming simply from higher taxes.

[Rehman Chishti (Gillingham and Rainham) (Con)]

I support everything that has been said so far about doing whatever we can to preserve life. Funding has been mentioned, as have the community and voluntary sectors. Medway contains the Wisdom hospice, where £539,000 is raised annually by the voluntary and charitable sectors. That is a great example of how communities want to preserve and support palliative care.

[Robert Halfon]

My hon. Friend makes a good point that is exactly right; his constituency is lucky to have him serving it so well.

I want to highlight bereavement counselling services. St Clare offers such a service, and about 40% of families that become involved with it receive bereavement counselling. That is a huge extra cost for something that the hospice does not have to provide but nevertheless offers as an extra service. Hospices receive little recognition for their work on bereavement care, and a UK study has shown that such care is often overlooked. In 2010, more than half of hospital maternity units still lacked dedicated bereavement support, thus leading families to turn to their local hospices. In 2007, an Oxford university survey of bereavement care in 10 Marie Curie hospices around the country showed that, although there are some great services, such care is patchy or non-existent in other areas. That is why hospices such as St Clare that go above and beyond the call of duty in the bereavement services that they offer deserve recognition and extra financial support.

To conclude, I should like to comment on the remarks made by my hon. Friend the Member for Hexham (Guy Opperman) who is no longer in his place. I have huge respect for him, but he mentioned choice in death. The problem with assisted dying and the move towards euthanasia is that people will be pressured into making choices. That is why I am passionately against any move towards assisted dying.

[Robert Flello (Stoke-on-Trent South) (Lab)]

I congratulate the hon. Member for Enfield, Southgate (Mr Burrowes) on securing this debate, and I have been listening carefully to the hon. Member for Harlow (Robert Halfon). Is not part of the problem the fact that if this House eventually—sadly—legislates in favour of assisted dying, that would normalise the situation and mean that people and families who are vulnerable or in desperate straits may think, “That is normality; we will go down that route”? Does the hon. Gentleman agree that that is a dangerous route down which to go?

[Robert Halfon]

I agree passionately with the hon. Gentleman; we would be taking a hugely dangerous step were we to go down the road of assisted dying. We as a society devalue human life, whether through fiction, computer games or television, or in real life. I often wonder whether Harold Shipman would have got away with killing one patient after another if we as a society had not devalued human life in such a way. We need to move away from that in a big way and back towards dignity for the dying and strong support for palliative care.

Oral Answers to Questions

Robert Halfon Excerpts

Tuesday 10th January 2012 Commons Chamber

[Mr Lansley]

Let me remind the hon. Lady—she might not have noticed this—that before the Christmas recess I announced funding for the next financial year for all primary care trusts in England, and the increase for all primary care trusts is 2.8%. In contrast to the previous Government, we are setting out to reduce health inequalities, not least by focusing resources on public health on the basis of an objective measurement of disparities in health outcomes.

[Robert Halfon (Harlow) (Con)]

A BBC Essex investigation into Rushcliffe’s Partridge care home in my constituency has uncovered shocking allegations of abuse and neglect. Will the Minister urge the Care Quality Commission to step in now with an inquiry and take whatever legal action is necessary to protect the elderly residents? Will he meet me and my constituent Lesley Minchin who has a relative who has suffered as a result of what has been going on in the care home?

[The Minister of State, Department of Health (Paul Burstow)]

I certainly share my hon. Friend’s concerns. BBC Essex’s reports of abuse and degrading treatment in that care home are cause for concern. The CQC is due to publish a report shortly and I am certainly happy to meet my hon. Friend to discuss the matter further. The Government are determined to shine a light on abuse wherever it is found and to root it out of the system to ensure that people are treated with dignity and respect and get the care they need.

Oral Answers to Questions

Robert Halfon Excerpts

Tuesday 22nd November 2011 Commons Chamber

[Anne Milton]

I am happy to join my hon. Friend in congratulating Kent county council. As he rightly points out, these moves have been welcomed by many local authorities, many of which already do much to improve the health and well-being of their populations. It is extremely important that councils are eager to start, as I know they are, and eager to get that money and see the public health outcomes framework so that they can build on some of the good work they have already done.

[Robert Halfon (Harlow) (Con)]

Harlow has one of the highest levels of obesity in the east of England. Will my hon. Friend ensure that the resources that are directed to local authorities are properly used to solve such problems?

[Anne Milton]

Yes, this is not only about resources, as my hon. Friend rightly says. Some 60% of adults are overweight or obese, and those figures are even higher in some areas. It is extremely important not only that any money is followed by that public health outcomes framework, but that it is effective. This is not something we can simply chuck money at, as the previous Government did.

Winterbourne View Care Home

Robert Halfon Excerpts

Tuesday 7th June 2011 Commons Chamber

[Paul Burstow]

The local authority was notified in the same way, so there are a number of agencies at which we need to look carefully and critically, and that is what the independently chaired serious case review will do. That is what the review by the CQC is about, and we will pull all those reviews together. If there are any gaps in the information that comes from that process, we will make sure that they are filled. However, the key thing is that lessons are learned along the way and changes are made straight away.

[Robert Halfon (Harlow) (Con)]

Further to what the hon. Member for Hampstead and Kilburn (Glenda Jackson) said, given that the CQC clearly ignored the advice it was given, there should be resignations at the highest level—the buck has to stop somewhere.

[Paul Burstow]

I am afraid that I am not going to agree with the hon. Gentleman today that we should call for anyone’s head. I want the heads of that organisation to be relentless in pursuing the questions that hon. Members have asked today and which I have asked since this came to light about why failures occurred—not just the CQC’s acknowledged failure but failures by others in allowing this to go on for the time it did. I am not calling for resignations, but I am calling for action and resolution. Learning should take place, and there should be change as a result of that learning.

Childhood Obesity

Robert Halfon Excerpts

Tuesday 3rd May 2011 Westminster Hall

[Robert Halfon (Harlow) (Con)]

I congratulate my hon. Friend the Member for Brentford and Isleworth (Mary Macleod) on securing and opening the debate. She showed an incredible level of expertise and was thoughtful in her remarks. We have had our own discussions about food, and I look forward to having many more in future.

I confess that I was hesitant about speaking in the debate today. It is difficult to talk about obesity, including childhood obesity—and we have a serious problem in Harlow—in a way that does not upset people. When I have spoken about it in the past, I have had many letters and e-mails from anguished individuals and residents. Nevertheless, I decided to go ahead today because the issue is so important and must be dealt with.

Some take the view that the only way to solve obesity is by encouraging people to go on a diet. I do not take that view. Dieting is essential, but obesity problems are very much about parenting, education and health. One of the best books that I have read about food—I read it almost in one sitting—was called “The Hungry Years” by William Leith. The author talks about his addiction to food, describing food almost as a drug. He went on the Atkins diet but, although he addressed that addiction, he went on to another—from memory, drugs. It was only when he dealt with the reasons for his compulsive behaviour that he ultimately managed to lose weight. It is a very important book.

I know how difficult diets are, having had to be on diets as a child because of my walking. As hon. Members understand, diets sometimes feel like walking up a hill with a boulder, like Sisyphus in the Greek myth: as soon as we get to the top, we see the boulder roll down, and we have to start again.

As well as having obesity and childhood obesity problems, Harlow has some important sporting organisations for young people. I want to talk about them; they are very much part of the big society. We have the Harlow athletics club, the Harlow gymnastics club and the football club Kickz, as well as strong candidates for the Olympics and Paralympics such as James Huckle and Anne Strike. We have probably the finest sports Leisurezone in the country, run by a non-profit making trust, which is another example of the big society. However, we still have the problem of obesity.

As my hon. Friend set out, Harlow is not alone in having such problems. Over the past 13 years, the United Kingdom has seen an unprecedented rise in obesity, especially in childhood obesity. The proportion of children aged two to 10 who were overweight or obese increased from 22% in 1995 to 28% in 2003. If the number of obese children continues to rise, such children will have a shorter life expectancy than their parents do.

My constituency of Harlow has significant challenges of its own. Sadly, by the time that Harlow children finish primary school, one in three is overweight; and one in five has the most challenging weight problems and is considered obese. Harlow has the highest such figures for any of the 12 district councils in Essex. I mention that not to criticise anyone—I am proud of my constituency and residents, and I do not want to cause offence—but because such problems cannot be swept under the carpet.

Clearly, some of the obesity problem is down to parenting, but it is also down to the McDonald’s culture that we live in. We do not even have to get out of the car these days; stopping off for fast food is so much easier than going to the supermarket and having to cook ingredients from scratch. I have a confession to make: I happen to love McDonald’s. As for most people, it is a treat, providing value for money and affordable meals. It has made progress, with the preparation of chicken salads and so on. The problem is when people eat there regularly, as if it were an extension of their kitchen.

The second reason for the obesity problems is the big retailers and food companies. At an all-party group meeting with Kellogg’s, I asked why all its cereals have so much sugar—cornflakes, or whatever they might be. The people from Kellogg’s said that some of the company’s cereals did not have so much sugar, and that it has non-sugar brands. However, we never see those non-sugar brands advertised or displayed prominently. As with everyone else, I go to the supermarket, but I would not have a clue about what a non-sugar cereal from Kellogg’s is, and yet I would know about its cornflakes and the rest, because those are the ones advertised.

Schools have made a lot of progress with their meals, following the media campaigns of recent years. Jamie Oliver, who has been mentioned, was successful partly because he was not the man or woman from Whitehall, although there is always the risk of bureaucracy when we deal with such things. I have a short anecdote on that subject. I visited a school in my constituency that wanted to give fresh fruit to its children every day. Instead of being able to buy it from the greengrocer down the road, the school had to order it through a centralised fruit planning system set up by the bureaucracy. A fruit co-ordinator was needed, to count the number of pieces of fruit, and how much was eaten and left. That shows the ludicrousness of what happens when big government gets in the way.

Why does Harlow have a unique problem? There are many reasons for general obesity, but they do not explain the specific problems in my constituency. The truth is that the tale in Harlow is of two towns. In many ways, it is an ambitious and enterprising place, with a culture of hard work. We have more than 2,500 private businesses, which makes us one of the most entrepreneurial towns in Essex, but according to the latest comprehensive study in 2007, Harlow also has housing estates with pockets of some of the worst deprivation and poverty not just in the region, but in England as a whole. That impacts on everything: homelessness, unemployment, literacy and numeracy, family breakdown, crime, and of course health. Obesity is just one symptom of the broken society, but is that because of poverty, or educational poverty?

When it comes to solutions for obesity, it is fair to say that big or grand Government diet schemes do not work. Television adverts a few years ago urged us to eat fruit and said that it was wrong to have a bottle of wine with dinner. Many parts of the UK are still awash with NHS adverts covering the landscape with the same advice. In 2009, the Food Standards Agency—a quango that survived the bonfire—announced a scheme to encourage restaurants to give calorie counts beside each dish. The Department of Health has told us that we are all eating too much saturated fat, but despite all those worthy initiatives and their cost for taxpayers, obesity has gone up and up.

I am a Conservative because I believe in choice, freedom and the right of individuals to make their own decisions. Big state or “nanny-knows-best” programmes usually cost a lot, and do not achieve what they are intended to achieve, however noble they are. One thing that sticks in my mind about the Jamie Oliver success is that parents came to the school and tried to thrust fried Mars bars through the gate. The reason was partly lack of education, but also resentment at being told what to do by the big state. They were the parents, and they wanted to decide what to do with their own children.

People are not chess pieces to move around a board. We cannot design a Government scheme that will magically repair people’s lives, but I accept that we must not abandon people. The solutions must come from the communities and neighbourhoods that we live in. That is an old idea, but it has been given fresh impetus by the big society reforms.

We have some remarkable sporting groups in Harlow, which are very popular. They are run by volunteers and social entrepreneurs, who know how to stretch a few hundred pounds to have the greatest impact with as little bureaucracy as possible. Such big society groups need more support. If we diverted just 1% of the sin taxes on cigarettes—around £209 million a year, based on 2010 figures—and if the same were applied to alcopops, excessively fatty foods and high-sugar products aimed at children, and that money was then funnelled into the big society bank, the Big Lottery Fund or local funds and ring-fenced specifically for smaller grass-roots charities, that would really make a difference. It would transform childhood obesity. That incentive could work in many ways. Supermarket vouchers that are currently used for school equipment could also fund sports charities in the community.

Community support officers on the Berecroft estate in Harlow have a regular Saturday football game with local children, and organise it with the Berecroft residents association. All they need is a few hundred pounds to connect their floodlights to mains electricity. Small amounts of money can make a huge difference, and millions of pounds are not always needed, because small community groups are best at fighting obesity. Another example is Harlow gymnastic club. It has many members, and the cost of joining is very small. It has changed the lives of countless young people and those with significant health problems, but it struggles to access funding because it is not part of any grand Government diet scheme.

I have often said that, if the big society, or even the big-boned society, is to work, we must build the little society. That is why I urge the Minister to focus on sustainable funding for smaller, grass-roots charities, as well as national organisations.